Editorial

Welcome to the December 2009 edition of i2p - Information to Pharmacists E-Magazine.When i2P first began in February 2000, it was decided that a fortnightly publication might prove to be the optimum publishing cycle.This thought was soon dispelled as it was found that having sufficient content to maintain this cycle became a problem.Oh for those quieter times!The cycle then became monthly and has been maintained up to now.The problem is now coping with the volume of news and opinion that is generated on a daily basis.Very much the reverse of the year 2000 - a statement for our time and how the pace of pharmacy life has increased.

For some pharmacists the truth will be ‘inconvenient’. WHY is it so??

Sir Winston Churchill said “Truth is incontrovertible, malice may attack it and ignorance may deride it, but, in the end, there it is.”Elvis Presley said “Truth is like the sun. You can shut it out for a time, but it ain't goin' away.”

At the PAC 2009 Conference John Menadue’s forthright messages made it abundantly clear that the sun was shining very brightly indeed. Here are the ‘message sticks’ that resonated with me:

About that "Un-Invitation"

It was interesting reading John Menadue’s speech given at the Pharmacy Australia Congress in Sydney in October.It was even more interesting to read of the UN-invitation by the Queensland branch of the College of Pharmacy Practice and Management, the stance taken by the Pharmacy Guild of Australia and the Pharmaceutical Society, to support only pharmacy activities provided from within a community pharmacy. How draconian is that? Research has demonstrated, as has the low uptake of new professional services from within a community pharmacy, that the existing community pharmacy model is not compatible with the implementation of these new professional opportunities. The two major arguments put forward are ‘lack of time’ and ‘lack of funding’.

A Green Pharmacy is Gold

Simon Divecha, Director of GreenMode, a consultancy that assist business and people to find their carbon and sustainable advantages spoke at the recent Pharmacy 2009 Conference. Simon has assisted businesses including BP Solar, Origin Energy, Lend Lease, ANZ and IAG. His challenge to community pharmacy is to identify and take advantage of the opportunities that exist for businesses that have such close relationships with their local communities.

What are we doing to ourselves?

Over the last months, I've noticed the position taken by both the Guild as well as individual pharmacists on our on-line forums.

In his recent address Mr John Menadue poses the question - are pharmacists the most change-resistant health profession?

And if so, what is our future likely to hold? What can we do about it?

Personally, I have to agree with him - if we as a group - and not just the Guild, DON'T take innovation as a prerequisite for how we practice our profession, then in 20 years time, what will we have left?

Picture - the wood for the trees

Another year has gone by and what have we done with technology in the health sector? A good question that deserves a long and detailed review as a written dissertation by somebody learned and influential in health informatics, government, consulting or from the many agencies, departments and committees engaged in delivering e-health service to the Australian public; notably as a value proposition for the tax payers in the greater voting public cohort.

Advancing Self Care

Imagine a pharmacy that had a range of eye catching kiosks that utilised easy to use touch screen technology.Not passive kiosks, but kiosks that are interactive with customers/patients to efficiently provide a perceived need.It’s not a new idea, but the marketing of health care through kiosks certainly represents an organised method of transferring information to customers/patients and assisting them to make good health decisions.One current form of kiosk that is beginning to take hold in Europe and the US is the vision kiosk.

Wind Farm will Power Sydney's Desalination Plant

Communications Technology - a nudge from the big end of town

National Health IT assumed prominence recently when the National Business Council of Australia wrote directly to prime minister, Kevin Rudd, urging him to create a focus on communications technology and to invest appropriate funds.I wonder if they were aware of the organisational performance 0f NEHTA and their inability to date, to actually deliver suitable infrastructure and systems.And with $'s millions already wasted by NEHTA I am sure there is hesitancy by government to spend even more, given the dismal track record to date.Health communications is stuck in a deep groove.But it is interesting to note that the Business Council of Australia see productivity and investment opportunities in health if only the primary health players could integrate better and talk to one another.Shared health communications underpins this potential benefit as the many writers for i2P have continually pointed out.With the big end of town taking more interest, maybe government and health professionals can align themselves more fluidly.A read of David More's blog article from a NEHTA insider in this edition of i2P, leaves you still wondering how an alignment can take place without removing the NEHTA structure completely.

Powering up by osmosis

An unusual form of renewable energy has emerged recently in a novel format involving the use of fresh water and salt water interaction across a membrane that creates osmotic pressure.This pressure has been demonstrated to be able to drive a turbine that can produce an electric current.Osmotic pressure is well known in medicine with adjustments having to be made to eye drop and injection formulas to minimise the pain associated with the administration of these medicine forms.The process is a more controllable form of natural energy when compared with weather-dependent versions of energy generation (solar, wind, tidal etc) and has a reasonably small and discrete footprint in the environment.With a bit of imagination it is not too far of a stretch to have the salt water filtered through another form of membrane to create fresh water to be recycled within a closed system.

Norway tries osmotic power to harnessing power of salt

Insuring the Disabled

Prime Minister Kevin Rudd is to be commended for the initiative in having a look at the feasibility of creating a no fault disability insurance scheme.Disability can cause disaster to any family structure and can be a constant drain on financial resources that can add to further stresses up to, and involving bankruptcies.By putting in place a proper financial underpin, each family member is enabled to be productive and self-sustaining. This can create a net gain to the taxation base when viewed globally, to include service providers and industries that can feed off that activity stream.

Should patents apply to the natural world?

I can't but help wonder if the move to be able to patent all things natural is a smart move.Take for example the Neam tree that grows wild in the northern part of Australia.The leaves of this tree make a great insect repellent with no known side effects.An entrepreneurial Australian a few years back, decided to grow these trees and was surprised to have legal documents served on him claiming royalties and damages from some obscure US company that had registered a patent for all things Neam.Unfortunately, there was no legal defence for the Australian grower.Now there is an outcry by vested interests because the Australian government has resisted pressures to allow the patenting of human genes.All sorts of calamities are therefore predicted for the local biotech industries.But I wonder if these claims will prove to be valid?

Public Hospitals - Time they were fixed

Queensland Health struggles through another drama after using instruments that had been used on patients and left unsterilised. But it's not just Bundaberg Hospital that is sick - the entire Australian hospital system needs a radical overhaul. The Rudd government had promised to "fix" the problem after taking office, but so far has not made any noticeable progress. Read about the latest problem.

Patient uses initiative to attract nurses

If anyone has ever been a patient in a hospital and tried the buzzer to get assistance from a nurse, then here is a new innovation to get attention.Not that the nursing fraternity should shoulder the blame.It's the politicians and the lack of political will to solve this issue and many others.Congratulations to the patient and his initiative in dialling triple O.Read the full story here:

What's good for climate is good for health

Health professionals from around the world are slowly waking up to the fact that climate change can induce adverse effects on health.At i2P we have been carrying messages for just on two years, regarding climate change effects, including research reports from our own writer Con Berbatis, in the hope that official pharmacy would see the need and develop policies and strategies for pharmacists to adopt.Now, with the formation of the International Climate and Health Council a recognised forum is available to be addressed.Will pharmacists be given a seat at the table?Perhaps the Pharmaceutical Society of Australia should find out.

Health Professionals Around The World Launch The International Climate And Health Council

Ageing slowly and safely

The ageing process is relentless with function loss noticeably diminishing over the age of 60.Supplementation of nutrients holds one key to slowing down some of the processes, in particular the loss of muscle mass and the subsequent aches and pains that follow as the skeletal system is no longer held together in an optimum manner.This process can be a contributor to falls and more serious damage.Not being able to adequately stay on your feet as you age, robs you of your independence.It would seem that a strategy of slowing down slowly might be prudent for the age demographic entering retirement - the "baby-boomers".Antioxidants could help preserve muscle strength

Are we planning for future skill shortages?

National Seniors Agency have published a report indicating that Australia will have a shortfall of 1.4 million workers by 2025.This shortage will also be reflected in the profession of pharmacy.It is pointed out that a smart move would be to match an improved workplace to match specific requirements for mature-aged employees and thus retain them for longer periods..APESMA has recently published an online survey in an endeavour to poll employed pharmacists on the issues that affect them specifically. Obviously, this is a move in the right direction, and much of what they are polling has a direct relationship to mature-aged employees.

So what is community pharmacy doing to retain their senior pharmacists?

Advancing Self Care

Neil Johnston

Neil Johnston is a pharmacist who trained as a management consultant. He was the first consultant to service the pharmacy profession and commenced practice as a full time consultant in 1972, specialising in community pharmacy management, pharmacy systems, preventive medicine and the marketing of professional services.
He has owned, or part-owned a total of six pharmacies during his career, and for a decade spent time both as a clinical pharmacist and Chief Pharmacist in the public hospital system.
He has been editor of i2P since 2000.

Imagine a pharmacy that had a range of eye catching kiosks that utilised easy to use touch screen technology.Not passive kiosks, but kiosks that are interactive with customers/patients to efficiently provide a perceived need.It’s not a new idea, but the marketing of health care through kiosks certainly represents an organised method of transferring information to customers/patients and assisting them to make good health decisions.One current form of kiosk that is beginning to take hold in Europe and the US is the vision kiosk.

The kiosk includes an eye chart and vision health information, along with lists of local eye doctors and optometrists (some pay for preferred listings) and messages from sponsoring partners such as contact lens manufacturers. In addition, the kiosk also presents an opportunity for customers to talk to the pharmacists more often and to purchase eye-care products in nearby OTC departments.

The strategy is to convert customers to patients.

A sizable percentage of the population has never had an eye exam, so this may help them with their eye health.

In a recent survey, more than half (54.6 percent) of those surveyed reported receiving an eye exam once every two to three years, and 6.2 percent reported receiving an eye exam only after four or more years, or "whenever needed."

Cross-merchandising and marketing opportunities can be explored with the kiosks including OTC eye-care products, such as reading glasses and eye drops.

Blood pressure represents another type of kiosk opportunity that also generates customer interest and interaction. The introduction of electronic blood pressure machines into pharmacy was originally done in kiosk format and was very successful in generating fees and referrals to doctors by pharmacists.

Well trained clinical assistants can supervise and control most kiosk functions.

At the centre of most kiosks is a touch screen computer.

For the majority of kiosk applications, touch technology is the first choice for the user interface. Indeed, it could be argued that touch technology has been largely responsible for the success of many kiosks since the touch interface is universal and can be used by anyone, regardless of language, education or socioeconomic and cultural background. However, over the years a number of different touch technologies have emerged and just randomly choosing any of them will not necessarily result in a successful project. Many self-service terminals and kiosks are high-risk business projects and could fail at the pilot stage through poor implementation or wrong choice of technology.

Over the last four decades, touch technology has gone from technology restricted to high-end, high-value applications such as air traffic control towers to mainstream personal computing with touchscreens now appearing on the desktop and lately the mobile phone industry which has adopted touch technology with a vengeance. Kiosks for public use have always been a leading application area for touchscreens as the technology is uniquely suited to making a complex computer interface simple to use by anyone.

Technology-wise, there is a wide range of options for designers each with its own particular strengths.

Apart from imparting information and education to consumers, kiosks can be applied for other purposes.

One useful purpose is “queue-busting” and one has only to check out the local Road Transport Authority office or the Centrelink office and be amazed at the lack of queues and quiet efficiency that has replaced chaos and confusion.

Kiosks have been utilised to schedule client appointments with actual service officers being decentralised around the total office, removing congestion and aggregation of numbers of people.

Perhaps this is an idea for use in a dispensary, or at least the area immediately in front of the dispensary. It is possible that patients could be trained (or assisted) to use a kiosk to input all their details and be given some form of priority dispensing.

This type of operation could definitely ease peak events in the dispensing production line, while simultaneously reducing costs.

Clinical assistants would need to be on hand to initially persuade patients to utilise the technology and then to answer any questions that may arise from the interaction.

Remember, patient waiting time (as judged by the patient) begins when prescription details have been imparted to the pharmacy – in this case to one or more dispensary kiosks. Patients will very quickly gain the impression of a speedy and efficient dispensing system without the need to compromise safety.

Kiosks represent an opportunity to spearhead a profit centre, provided it is well thought out.

The design must be compact, eye catching and have an array of information and directional signage for customers/patients to interact with the kiosk with minimal need for staff.

But well trained and qualified staff should be on hand to educate and assist.

The kiosk focuses attention on the goods and services available and assists in the referral to other health practitioners, if necessary.

A variety of kiosks can be implemented in a store layout to disperse customers/patients across the full area of a pharmacy – they are store directors and they can convert low sale products into higher performers just because of the traffic flow generated.

And they represent a method for the systematic distribution of information – the core currency of pharmacy.